IBS

Question 1

What are some of the symptoms for IBS?

Answer 1

Diarrhoea.
Constipation. 
Fluctuating bowel habit.
Abdominal pain.
Bloating. 
Worse after eating.
Improved by opening bowels.

Question 2

What tests are done to exclude other things when diagnosing IBS?

Answer 2

IBS is done by diagnosis of exclusion:
They should have normal FBC, ESR and CRP blood tests.
Faecal calprotectin is negative to exclude IBD (where it is positive).
Check for anti-TTG antibodies as a high level indicates Coeliac.
Cancer should not be suspected.

Question 3

What symptoms are needed to diagnose IBS, once other conditions have been ruled out?

Answer 3

Abdominal pain/ discomfort relived by opening of the bowels and two of:
Abnormal stool passage.
Bloating.
Worse symptoms after eating.
Mucus with stools.

Question 4

General healthy advice such as less alcohol, processed food and caffeine consumption is recommended for IBS, however what first line medication is available?

Answer 4

Loperamide for diarrhoea.
Laxatives for constipation
(avoid lactulose as it causes bloating and linaclotide is specialist laxative for IBS patients not responding to first line laxatives.
Antispasmodics like buscopan for cramps.

Question 5

What is second line medication for IBS?

Answer 5

Tricyclic antidepressants - amitriptyline taken at night.

Question 6

What is third line mediation for IBS?

Answer 6

SSRIs antidepressants.

Question 7

What is the Rome 3 criteria?

Answer 7

It is the way of diagnosing IBS.

Recurrent Abdominal pain for at least 3 days of the month for 3 months + two of:
Improvement with defecation.
Onset associated with a change in frequency of stool.
Onset associated with a change in appearance of stool.

Question 8

What are the psychiatric problems that come with IBS?

Answer 8

Having a mental problem gives you a higher chance of getting the condition.
50% are thought to be depressed, anxious or hypochondriacal.